Arytenoid adduction

Arytenoid Adduction

Diagram illustrating arytenoid adduction

Arytenoid adduction is a surgical procedure used to treat certain types of vocal cord paralysis, particularly unilateral vocal cord paralysis. This procedure aims to improve voice quality and prevent aspiration by repositioning the paralyzed vocal cord closer to the midline of the larynx.

Anatomy of the Larynx

The larynx, commonly known as the voice box, is an organ located in the neck involved in breathing, sound production, and protecting the trachea against food aspiration. It houses the vocal cords, which are essential for phonation. The arytenoid cartilages are two small, pyramid-shaped structures located at the back of the larynx. They play a crucial role in vocal cord movement and tension.

Indications for Arytenoid Adduction

Arytenoid adduction is primarily indicated for patients with unilateral vocal cord paralysis, where one vocal cord is immobile. This condition can result from various causes, including surgical trauma, neurological disorders, or idiopathic reasons. Symptoms of unilateral vocal cord paralysis include hoarseness, breathy voice, and aspiration of liquids.

Surgical Technique

The procedure involves repositioning the arytenoid cartilage of the paralyzed vocal cord. This is typically achieved by suturing the arytenoid cartilage to the thyroid cartilage, thereby rotating it medially. This medialization helps bring the paralyzed vocal cord closer to the midline, allowing for better closure during phonation and swallowing.

The surgery is often performed under general anesthesia. A small incision is made in the neck to access the larynx. The surgeon identifies the arytenoid cartilage and places sutures to achieve the desired position. The procedure may be combined with other techniques, such as medialization thyroplasty, to further improve vocal outcomes.

Postoperative Care and Outcomes

After arytenoid adduction, patients may experience some swelling and discomfort, which typically resolves over time. Voice therapy is often recommended to optimize vocal function and improve outcomes. Most patients report significant improvements in voice quality and a reduction in aspiration risk.

Complications

As with any surgical procedure, arytenoid adduction carries potential risks and complications. These may include infection, bleeding, or damage to surrounding structures. Rarely, patients may experience persistent hoarseness or difficulty breathing if the vocal cords are over-medialized.

Related Pages

• Vocal cord paralysis
• Larynx
• Medialization thyroplasty
• Phonation